Medicare Supplement Plans - Status Tracker | Mutual of Omaha

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Plans F, G, and N

¹Only Plans D, G, M, N, C, and F include the foreign travel emergency benefit. Your Medicare eligibility date must be before Jan. 1, 2020 in order to purchase plans C and F.

**Based on Mutual of Omaha 2022 claims data and affiliate companies 2022 data for all claims, not just Medicare supplement insurance claims.

Product base plans, provisions, features and riders may not be available in all states and may vary by state. Exclusions and limitations may apply.

Important Disclosure Information

Medicare supplement insurance policy forms are underwritten by Omaha Supplemental Insurance Company, 3300 Mutual of Omaha Plaza, Omaha NE 68175. Policy Forms: SM20-50074, SM24-50075, SM25-50076, SM35-50078, SM36-50077 or state equivalent. Not all policy forms may be available in every state. Select policy forms are only available to individuals who turn 65 before January 1, 2020.

An outline of coverage is available upon request. The Guide to Health Insurance for People with Medicare is also available from your state Department of Insurance or the Centers for Medicare and Medicaid Services.

Your Medicare supplement Insurance policy has the following exclusions and will not pay for: expenses you incur while your policy is not in force; except as provided in the EXTENSION OF BENEFITS section; your confinement in a hospital or skilled nursing facility during a Medicare Part A benefit period that begins while your policy is not in force; any expense you incur which is paid for by Medicare; non-Medicare-eligible expenses, including, but not limited to, routine exams, take-home drugs, and eye refractions; services for which a charge is not normally made in the absence of insurance; or loss or expense that is payable under another Medicare supplement insurance policy or certificate. Coverage may vary by state.

In some states, if you receive Medicare benefits because of a disability, you may apply for a Medicare supplement insurance policy regardless of your age.

Your coverage starts on the policy date 12:01 a.m. where you reside. It ends at 12:01 a.m. where you reside on the first policy renewal date. Each time you renew your policy by paying the premium within the 31-day grace period, a new term begins when the old term ends. You may cancel your policy at any time by giving us written notice. Your policy will terminate on the earliest of the date we receive your request to cancel the policy, your coverage is replaced by another Medicare supplement insurance policy, the required premium has not been paid before the end of the grace period or the date of your death. In the event of cancellation or death, we will promptly return the unearned portion of any premium paid. Termination will not affect any claim that began while your policy was in force.

Licensed insurance agents/producers are authorized to sell this Medicare supplement insurance policy on behalf of Omaha Supplemental Insurance Company.

This information may be verified by contacting the Omaha Supplemental Insurance Company, 3300 Mutual of Omaha Plaza, Omaha, NE 68175. Toll Free 1-800-228- 7104. In Ohio, contact the Ohio Department of Insurance, 50 W. Town Street, Third Floor, Suite 300, Columbus, OH 43215. Consumer Hotline: 1-800-686-1526 or TDD Number (614) 644-3745.

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